The present invention relates to a system and method for generating identification cards.
Most providers of insurance coverage or benefits issue identification cards to members/employees of contracting organizations to identify members that are eligible for coverage or benefits. This is particularly true for health care and dental benefits providers. The identification cards are used by the providers of coverage or benefits to identify membership, facilitate access to care, provide information about health care coverage, allow branding and recognize health care providers.
In order to create the identification cards, a system operator affiliated with the provider extracts member eligibility information and business rules from multiple databases and transmits the information to identification card vendors for card generation using multiple systems. Each identification card system includes its own business rules that provide instruction as to how to generate the identification cards. Business rules for creating identification cards among the identification card systems may be different. Examples of business rules include the amount the members of a particular contracting organization pay to health care providers for each office visit, certain disclaimers and text required by certain states or the provider.
To create a batch of identification cards for each contracting organization, the system operator synchronizes the appropriate business rules from each identification card system and chooses a font type and an identification card stock. Some providers have thousands of different font types and hundreds of different card stocks from which to choose. Moreover, the card design for each contracting organization may be unique based on the agreement between the contracting organization and the provider.
Upon selecting the font type and identification card stock, the system operator transmits to the vendor multiple files along with the business rules associated with each particular contracting organization. In some cases, errors may be generated during the transmission and/or the vendor may not receive some files. Thus, each vendor must manually reconcile all files received. The system operator must also design the graphics for each card and transmit the graphics to the vendor. Some contracting organizations have multiple graphic designs. Typically, vendors charge the provider for each design required. Upon receiving the files, the vendor determines how to program into the vendor""s system the graphics, business rules, font types and other information contained in the files. The vendor may create a paper copy of an identification card for each contracting organization that is faxed to the provider for review. Upon final approval from the provider, the vendor creates a batch of identification cards for each contracting organization by implementing the appropriate program(s). The vendor mails the batch to the organization or the individual members.
Apart from the cumbersome and inefficient process of faxing a paper copy of the identification card to the provider, this system and procedure does not allow the provider to view an image of the identification card prior to its being distributed. This system and procedure also forecloses the possibility of accessing the data representing the identification card electronically, such as over a global communications network or by a voice response unit. Furthermore, the provider is forced to rely on vendors for a key customer deliverable (i.e., the identification card).
Additionally, in order for the contracting organization to obtain customized identification cards (such as identification cards with the contracting organization""s logo), the identification card vendor must program each customization into the vendor""s system. Thereafter, the vendor must implement a customization program to print the customized identification cards for members of the contracting organization. Moreover, in the event a change must be made to an organization""s identification cards, for certain types of changes, the provider must inform the vendor of the change and the vendor must then determine how to program and implement the change in their system. For example, if the provider wants to change the amount that members pay for office visits, the provider must inform the vendor of the new amount and the vendor must program the new amount and create the new cards by implementing a change in programming.
In this environment, there is a relatively high level of complexity in performing relatively minor changes, such as changing the physical placement of data items on the identification cards. Thus, for future use, providers may store multiple versions of physical identification cards that represent previously created cards. However, this is expensive and inefficient.
For these reasons, identification card production processes are manually intensive, inefficient and prone to misinterpretation and/or errors. Such problems cause about two and a half percent of all cards to be destroyed and reissued each year. Therefore, the provider may spend a great deal of money and research time trying to determine, among other things, why a card did not get generated properly.
A currently available document generation system enables a programmer associated with the provider, rather than the outside vendor, to perform the programming. However, this system is relatively expensive since it requires a highly skilled programmer to be involved in implementing each batch of identification cards. The skilled programmer must also be involved in implementing relatively minor changes to existing cards and customizations of new cards. Moreover, this document generation system is incapable of creating a large volume of cards and is not useful to large providers. Also, the document generation system does not allow each identification card to be viewed prior to printing.
What is needed therefore, is a simplified identification card system for generating identification cards. The system must also be capable of being used with other electronic alternatives to reduce dependency on physical identification cards. The system must significantly increase the accuracy of identification card creation and minimize the cost associated with creating identification cards.
The present invention solves the problems associated with prior art identification card generation systems by providing a system and method for generating an identification card documentation data file representative of a high volume batch of identification card documentation items. Identification card documentation format information that corresponds to positioning of the identification card documentation content information on each of the identification cards in the batch is defined. Identification card documentation content information is extracted from one or more databases that include provider information, eligibility information, client information, benefits information and business rules. The identification card documentation data file is generated based on the identification card documentation content information and the identification card documentation format information.
Additional features and advantages of the invention will be set forth in the description that follows, and in part will be apparent from the description, or may be learned by practice of the invention. The objectives and advantages of the invention will be realized and attained by the system particularly pointed out in the written description and claims hereof as well as the appended drawings.